Neurology Flashcards

1
Q

A patient presents with a headache she describes as the “worse headache of her life” Patient is photophobic and seems to be in a state of delirium. What is your leading diagnosis?

A

Subarachnoid hemorrhage

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2
Q

What is the mechanism of a Subarachnoid hemorrhage?

A

MC: Berry aneurysm rupture; AVM

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3
Q

A patient presents with a headache she describes as the “worse headache of her life” Patient is photophobic and seems to be in a state of delirium. Subarachnoid hemorrhage is suspected. What is the next step in evaluating this patient?

A

CT scan preferred first

If CT is negative, do an LP

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4
Q

A patient presents with a headache she describes as the “worse headache of her life” Patient is photophobic and seems to be in a state of delirium. Subarachnoid hemorrhage is suspected. What is the best management for this patient?

A
Supportive: 
bed rest
stool softeners
lower ICP 
Surgical coiling or clipping
\+/- lower BP gradually (Nicardipine* ; Nimpdipine; Labetolol)
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5
Q

A patient presents with a headache she describes as the “worse headache of her life” Patient is photophobic and seems to be in a state of delirium. Subarachnoid hemorrhage is suspected. CT scan was unremarkable. LP is highly suggestive of subarachnoid hemorrhage. What would this LP look like?

A
Xanthrochromia (RBCs) 
Increased CSF (ICP) pressure
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6
Q

A patient presents with a headache she describes as the “worse headache of her life” Patient is photophobic and seems to be in a state of delirium. Subarachnoid hemorrhage is suspected. CT scan was unremarkable. LP is highly suggestive of subarachnoid hemorrhage. What is the next step in evaluating/managing this patient?

A

4 vessel angiography (after confirmed SAH)

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